Doctor Name: | MRS. JOANN KAMINSKI |
NPI Number: | 1114299633 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCAS |
License Number: | 122 |
Business Practice Address: | 504 E Elizabeth St Elizabeth City, NC - 279094404 |
Business Phone Number: | 2526190319 |
Business Fax Number: | |
Mailing Address: | 504 E Elizabeth St, ELIZABETH CITY |
State: | NC |
Postal Code: | 279094404 |
Phone Number: | 2526190319 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2012 |
NPI Last Update Date: | 01/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 122 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |